The international politics of global health now sharply focuses on China — how it (mis)managed the coronavirus outbreak, the alleged ‘hold’ the Chinese government has over the World Health Organization that purportedly hoodwinked the latter, ‘mask’ diplomacy that Beijing has used to quell umbrage from affected countries, Taiwan’s stunning success in containing the virus spread that has renewed calls to reinstate its status as a WHO observer, and a flurry of debates over the need for a global inquiry into the origins of the coronavirus pandemic.

Into this vortex steps India. Union Health Minister Harsh Vardhan will Friday take over as the Chairman of the World Health Organization (WHO)’s 34-member Executive Board, which decides the agenda for the World Health Assembly meeting, held twice every year.

Questions regarding what India should do with its WHO position fill news commentaries. Pressures are allegedly mounting from “like-minded democracies” such as the US and Australia, which want India to introduce a global inquiry to investigate where the coronavirus originated. JNU scholar Rajesh Rajagopalan recently argued that New Delhi should unequivocally support its ‘strategic allies’ on Taiwan and a global coronavirus review ramping up pressure on Beijing.

Other developments indicate that the Ministry of External Affairs (MEA) is weighing options with partners such as Australia, the US and France, particularly on the Taiwan issue, while coordinating with these countries to manage the human and economic costs of Covid-19. Calls that exhort the Narendra Modi government to take a hardline over China in Geneva misread how the global health landscape has fundamentally altered, resulting in the diminishing of the WHO, which gives India an opportunity to bolster the organisation’s legitimacy by flagging globally relevant issues.

Dr WHO in a fix

The WHO’s role in a crisis like Covid-19 is to provide technical assistance and emergency support to states exposed and at least be able to handle a pandemic owing to their health systems, and function as a catalyst for coordinating resources and personnel to places most affected.

But the WHO’s ability to discharge these functions has been blunted by two developments. First is the chronic underfunding over the past few decades and the rise of new philanthropic actors like the Gates Foundation, which have become a major force funding global health programmes on issues like polio, HIV-AIDS and malaria. The second is an immediate constraint — the ongoing geopolitical tussle between China and the US.

With the WHO lacking and China and the US bickering, the global effort to tackle the coronavirus has fallen on France and Germany, which have picked up the mantle with the International Monetary Fund (IMF), the influential Gates Foundation and the offshoots it funds, GAVI and the Global Fund. Combined, these forces have led the intergovernmental response around diagnostics, therapeutics and vaccines for Covid-19 by deploying capital and developing scientific efforts that could produce diagnostic breakthroughs to stem the spread of the coronavirus.

Where does this leave WHO? The health body has evolved to function as a convener that could provide global legitimacy to the efforts being spearheaded by philanthropic organisations and transnational partnerships with European support. The World Health Assembly acquires considerable importance to ensure these ongoing transnational efforts around diagnostics and vaccines are calibrated with national health agendas and priorities as countries battle Covid-19.

India’s choices in lead WHO role

India as the head of the WHO’s Executive Board can drive the Covid-19-related effort to ensure countries across the developing world have wide access to drugs, diagnostics and vaccines currently being developed.

India should also ensure existing WHO priorities like TB, HIV-AIDS and malaria, coupled with issues like polio and health systems, are not excised from multilateral discussions now that a pandemic is in play. Disease burdens in most developing countries continue to be dominated by these infectious diseases and have in fact increased because the health infrastructure was used to contain Covid-19. The plight of Indians afflicted with TB and AIDS and other morbidities should behoove Indian diplomats in Geneva to sustain global attention on issues like health systems and preparedness that have generally been given short shrift.

Does prioritising public health issues at the World Health Assembly absolve China? Not entirely but choices have to be made. The WHO’s coronavirus response has been lambasted by critics who felt the organisation has been too cozy with the Chinese regime. Yet, few critics note the WHO’s predicament — it had to cooperate with the Chinese regime to get the requisite information to mount a viable response; publicly chastising China, as the WHO did during the SARS epidemic in 2003, could have shut their access to the country potentially increasing global vulnerabilities. WHO officials had to balance the public health considerations with the political and economic imperatives to mobilise a workable Covid-19 response.

India will likely have to do the same. Pushing for Taiwan’s participation might assuage Washington but not Beijing if New Delhi sticks to endorsing a global coronavirus inquiry that will require Chinese support. Taiwan and a coronavirus inquiry appear to be mutually exclusive outcomes.

As Harsha Vardhan takes over the WHO Executive Board’s chairmanship from Japan’s Hiroki Nakatani on Friday amid prevailing political tensions, it is vital to realise that power politics does not neatly map onto international organisations where rivalries undermine patterns of technical interaction and cooperation, which have profound implications for issues like health systems and coverage, vaccine development and transfer of health supplies in the context of Covid-19. India cannot entirely evade the power politics but it should neutralise it to the benefit of billions reeling from the pandemic.

The author is Research Fellow, Institute of South Asian Studies, National University of Singapore. Views are personal.

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3 COMMENTS

What we look forward from W H O experts is not their ability to conduct research or guide policies. We look for people with proven experience in foreseeing epidemics, endemics and pandemics and clearly bring out the steps needed and not the usual advisories / guidelines crap. There are two Indian citizens in key positions in the W H O now. In my opinion, with due respects to them, both do not fit into the current pandemic condition of the world. Here are the reasons.
One of them is Dr Soumya Swaminathan, the Chief Scientist, acknowledged for her work on the use of molecular diagnostics for TB surveillance and care, to undertake large field trials of community-randomized strategies to deliver TB treatment to underserved populations. There is no proven experience in any disaster control hands on. The other is Dr Harsh Vardhan, the Health Minister of India who is also not with any such proven experience.
In this context let us recapitulate Dr Chen, 68 years the former Vice President of Taiwan, who holds a Ph D in epidemiology and human genetics from from Johns Hopkins and is an expert in viruses. At the height of the SARS outbreak which infected 671 people and killed 84 people in Taiwan, the government faced a crisis of confidence after the authorities sealed a contaminated hospital with more than 1,000 people inside who tried to kill themselves and people jumping out of windows, which was really chaotic. Chen controlled the situation and led Taiwan in its efforts to prepare for the next outbreak and established a disaster management center, increased production of protective gear and revised the infectious disease law, among other measures. His track record in the Carona period is as on May-9th-2020, Taiwan had only 440 cases and only 6 deaths as compared to the world figures of 5 million and over 300,000 deaths. Chen tried to warn the W.H.O. in late December about the potential for the virus to spread from person to person but was ignored presumably because China prevailed in this. Now Dr Chen has entered retirement, can W HO can at least now draft him?

Investigation of China and admission of Taiwan to WHO are both important for a healthy world. Since 2000, China has been the origin of various viruses which have attacked the world. So, their public health methods require scrutiny by the world body. Secondly, Taiwan is a prosperous country and has successfully combated COVID19 though a stone’s throw away from China. Keeping it out of WHO, nay, UN itself is unnatural and amounts to denial of facts.

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